Reduced incidence of cardiovascular disease in patients with type 2 diabetes through the integrated improvement of diabetes care by comparing two prospective observational cohorts in real-world clinical practice (JDDM 72).

Aim: To investigate whether any reduction in all-cause mortality and cardiovascular disease morbidity was found over the decade in type 2 diabetes on real-world practice.

Methods: A prospective observational study was performed by following two independent cohorts recruited in 2004 (n = 3286, Cohort 1) and 2014 (n = 3919, Cohort 2). The primary outcome was a composite of onset of cardiovascular disease and death.

Combined mitral valve replacement and coronary artery bypass grafting through a left thoracotomy after retrosternal oesophageal reconstruction.

A 74-year-old man with a history of retrosternal oesophageal reconstruction was referred for surgical treatment of mitral valve regurgitation and coronary artery disease. He underwent mitral valve replacement combined with coronary artery bypass grafting through a left thoracotomy. Combined mitral valve replacement and coronary artery bypass grafting through a left thoracotomy were feasible in this patient with a retrosternal neo-oesophageal conduit.

[Pulmonary Epithelioid Hemangioendothelioma:Report of a Case].

A 54-year-old woman with a lung tumor was admitted to our hospital for surgical treatment. Chest computed tomography (CT) showed a 16×14×10 mm nodule in left upper lobe. Flurodeoxyglucose (FDG)-positron emission tomography (PET)/CT revealed increased uptake in the nodule.

Remote simulator training of coronary artery bypass grafting during the coronavirus disease 2019 pandemic.

Objectives: The coronavirus disease 2019 pandemic presents in-person exposure risk during surgical education. We aimed to validate the feasibility of fully remote faculty-supervised surgical training sessions focused on coronary artery bypass grafting using a synthetic simulator and online videochat software.

Methods: This observational study organized 24 sessions of 2-hour remote training.

[Primary Pulmonary Paraganglioma:Report of a Case].

A 60-year-old woman with a lung tumor was admitted to our hospital for surgical treatment. Chest computed tomography (CT) showed a 23×21×20 mm nodule in the right lower lobe. Although the lung nodule was thought to be benign due to CT image findings, its size was apparently larger than that of CT image at four years ago.

Anomalous Origin of the Left Anterior Descending Coronary Artery in an Adult.

An anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease. Among the variants, an anomalous origin of the left anterior descending coronary artery from the pulmonary artery (ALADPA) is extremely rare. Here, we report a case of ALADPA in an adult that was treated with coronary artery bypass grafting using the left internal thoracic artery.

[Rare Case of Thymic Epidermoid Cyst;Report of a Case].

A 68-year-old man with a mediastinal tumor was admitted to our hospital for surgical treatment. Chest computed tomography (CT) showed a 33×20×20 mm mass in anterior mediastinum. Magnetic resonance imaging (MRI) showed a heterogeneous structure in the cystic component of the mass.

[Wedge Bronchoplastic Left Upper Lobectomy for Lung Cancer Patient with Abnormal Mediastinal Left Basal Pulmonary Artery].

A 65-year-old man with left lung squamous cell carcinoma was admitted to our hospital for operation. His tumor was located left upper lobe and invaded to the orifice of left upper bronchus. We diagnosed the tumor as cT2aN0M0 and intended to perform radical operation.

[Immunohistochemical Analysis of Krebs von den Lungen-6 (KL-6) Expression in Lung Tissue in Primary Lung Cancer Patients with High Serum KL-6 Levels].

We investigated sialylated carbohydrate antigen( Krebs von den Lungen-6:KL-6) expression in lung tissue and correlation between the expression and serum KL-6 level in the patients with primary lung cancer. Thirty-four primary lung cancer patients with high serum KL-6 levels( >500 U/ml) were evaluated. A coexistence of interstitial pneumonia (IP) was histopathologically evaluated and an immunohistochemical staining using a mouse anti-human KL-6 antibody (mKL-6) was performed.

[Cavernous hemangioma of the right cardiac chamber;report of a case].

Cardiac cavernous hemangioma is an extremely rare benign tumor. A 53-year-old female had undergone resection of left breast cancer 9 years before, and her clinical course had been uneventful for nearly 9 years. She then experienced sudden fatigability and palpitations.

[Cadiac lipoma of the right atrium;report of a case].

Cardiac lipoma is a rare benign tumor. A 42-year-old male was referred to our hospital to undergo thorough examination and treatment of a space-occupying right atrial lesion, detected incidentally by chest computed tomography(CT). After admission, it was diagnosed as cardiac lipoma by echocardiography, CT, and magnetic resonance imaging.

[Pulmonary blood flow measurement using magnetic resonance imaging (MRI) without contrast medium;comparison of phase contrast MRI and perfusion-ventilation scintigraphy].

To define the accuracy of pulmonary arterial blood flow (PA-flow) measured by phase contrast magnetic resonance imaging (PC-MRI), we compared the PA-flow data of PC-MRI with the data of perfusion-ventilation lung scintigraphy. Eighteen patients who preoperatively underwent PA-flow measurement using PC-MRI and perfusion-ventilation lung scintigraphy were evaluated. The PA-flow (cm3/sec) of MRI was calculated by multiplying maximum velocity (cm/sec) by region of interest (ROI) area (cm2) of measured main pulmonary artery using phase contrast method.

[Effect of dexmedetomidine on anesthetic requirements in cardiovascular surgery].

Background: An anesthetic-sparing effect of dexmedetomidine has been shown in several studies. We investigated the effect of dexmedetomidine on anesthetic requirements in 24 patients undergoing cardiovascular surgery.

Methods: Patients were randomly divided into two groups in which continuous infusion of dexmedetomidine was started before induction of anesthesia (DEX group, n = 12) or when closing the sternum (control group, n = 12).

[Surgical results of a video-assisted lung resection for lung cancer; does surgical approach affect patient's satisfaction of surgery?].

Ninety five patients with lung cancer who underwent a single lobectomy were studied. In these patients, 42 were underwent a video-assisted thoracic surgery (VATS) lobectomy with minithoracotomy (Va group), 43 were operated under a muscle sparing thoracotomy (Ms group) and 10 were operated under a posterolateral thoracotomy (P1 group). White blood cell (WBC) numbers, C-reactive protein (CRP) levels and visual analogue scale (VAS) scores in Va group were significantly lower than those in P1 group until 3 or 7 postoperative day (POD).

[Freestyle valve for right ventricular reconstruction in Ross operation; report of a case].

A 28-year-old man with active aortic valve endocarditis underwent emergency surgery. Because he had progressive congestive heart failure and uncontrolled infection. Aortic root replacement for Ross procedure was required because of complete debridment of infective tissue.

[Elderly patient with acute type A aortic dissection; report of a case].

A 93-year-old woman complained of severe back pain. Computed tomography (CT) and echocardiography revealed acute type A aortic dissection with enlargement of the ascending aorta, moderate aortic regurgitation and cardiac tamponade. Despite her age, the patient was able to support herself, and she and her family desired to have a surgical treatment.

[Comparison of postoperative lung function between segmentectomy and lobectomy in patients with lung carcinoma].

Background: To determine any potential advantages of segmentectomy, we compared preoperative and postoperative lung function of patients who underwent segmentectomy with those in patients who underwent lobectomy.

Patients & Methods: Between September 2001 and November 2003, preoperative and postoperative lung function, including DLco, was assessed in 43 patients with primary lung carcinoma. Of these 43 patients, 33 underwent single lobectomy (group L) and 10 underwent segmentectomy (group S).

[Bronchioloalveolar carcinoma illustrating difficulties in diagnosis and determination of operative management; report of a case].

A 56-year-old male was admitted to our hospital to treat for an abnormal lung shadow. Computed tomography (CT) revealed the shadow with ground-glass opacity that was 30 mm in diameter at left S6 lesion. Although transbronchial lung biopsy had been performed, histological diagnosis could not be made.

Epicardial radiofrequency ablation for chronic atrial fibrillation undergoing simultaneous on-pump beating coronary artery bypass grafting.

Off-pump coronary artery bypass grafting has become an attractive surgical alternative for myocardial revascularization because of the advantage of myocardial protection and other benefits of patients. However, it is still regarded as a controversial treatment for the coronary artery disease accompanied by atrial fibrillation (AF). A significant number of patients in need of coronary revascularization have chronic AF.

[Induction chemotherapy and radical resection for primary nonseminomatous mediastinal germ cell tumor (NSGCT); report of a case].

A 15-year-old male was admitted to our hospital for treatment of an anterior mediastinal tumor. The tumor was visualized by chest radiography 3 months prior to admission. Computed tomography (CT) revealed a heterogeneous solid tumor located in the anterior mediastinum.

[Thoracoscopic segmentectomy of the left upper division in a patient with endobronchial hamartoma; report of a case].

A 71-year-old man was admitted to our hospital for treatment of an endobronchial tumor. Although he was asymptomatic and chest radiography showed no tumor shadow, bronchoscopic findings demonstrated an endobronchial tumor with a villous surface occluding the bronchus of the left upper division. Endobronchial resection was abandoned because we could not directly observe the cervix with a bronchoscope.

[A case of thymic cyst with thymic hyperplasia].

A 70-year-old man was admitted to our hospital for treatment of an anterior mediastinal tumor. Although he was asymptomatic, an abnormal shadow was visible on chest radiography. CT revealed a heterogeneous tumor located in the anterior mediastinum.

[Re-dissection of aortic root without gelatin-resorcin-formalin (GRF) glue effect one year after aortic repair].

A 58-year-old man, who had undergone emergency graft replacement of ascending and total aortic arch using gelatin-resorcin-formalin (GRF) glue 1 year before, complained of progressive shortness of breath. Ultrasound cardiography revealed severe aortic regurgitation and dissecting aneurysm of aortic root. He underwent composite graft replacement with the aid of the right axillary artery perfusion and deep hypothermic circulatory arrest.

[Cardiovascular surgery in patients with Marfan syndrome].

The natural history of patients with Marfan syndrome is depressing, however, cardiovascular surgery can improve the prognosis. We reviewed the results of this surgical procedure for 10 years. Fourteen Marfan patients underwent cardiovascular surgery for a total of 21 times.

[Successful lingular segmentectomy using bronchoplasty in a patient with early hilar second primary lung carcinoma].

A 71-year-old man was admitted to our hospital with a small protrusive lesion at the lingular orifice of the left upper bronchus. He had undergone a right lower lobectomy and mediastinal dissection for lung carcinoma (large cell carcinoma, pT1N0M0) 14 months earlier. Early hilar squamous cell carcinoma was diagnosed by chest radiograph, CT and transbronchial biopsy.